Hi Mae...Yes, cryo is well tolerated so it is an option, especially
for the elderly or those suffering from other ailments.  A recent
multi-institutional study (see abstract below) achieved mediocre (IMO)
results using the latest cryo technique.  However, I've read posts by
individuals that suggest much better results can be obtained with a
cryo "artist".  Some of the generally recognized leaders in this field
are listed below...Best wishes and good health, Ron

Dr Duke K. Bahn
168 N. Brent St, Ste 402
Ventura, Ca 93003
Tel: 800-585-3082

Gary Onik MD
Director of Surgical Imaging
Celebration Health/Florida Hospital
Suite A-280
400 Celebration Place
Celebration FL 34747
Tel: 407-303-4228
Email: OnikCryo@aol.com

Dr. Fred Lee
Cryosurgery/Ultrasonographer
Rochester Urology,
Crittenton Medical Professional Building
1135 West University Drive, Suite 420
Rochester Hills, MI 48307
Tel: 248-650-4699

The Journal of Urology 2003; 170(4):1126-1130
Treatment of Organ Confined Prostate Cancer with Third Generation
Cryosurgery: Preliminary Multicenter Experience
KEN-RYU HAN*; JEFF K. COHEN*; RALPH J. MILLER*; ALLAN J. PANTUCK*;
DANIELO G. FREITAS; CARLOS A. CUEVAS; HYUNG L. KIM*; JAMES
LUGG†; STACY J. CHILDS†; BARRY SHUMAN*; MAURY A. JAYSON*;
NEAL D. SHORE*; YAN MOORE*; AMNON ZISMAN*; JOE Y. LEE*; ROLAND
UGARTE‡; LANCE A. MYNDERSE*; TORRENCE M. WILSON*; SUSAN D.
SWEAT*; HORST ZINCKE*; ARIE S. BELLDEGRUN*§
ABSTRACT
Purpose:
Cryosurgical ablation of the prostate is 1 approach to the treatment
of localized prostate cancer. Third generation cryosurgery uses gas
driven probes that allow for a decrease in probe diameter to 17 gauge
(1.5 mm). The safety, morbidity and preliminary prostate specific
antigen (PSA) results of 122 cases are reported.
Materials and Methods:
A total of 106 patients have undergone percutaneous cryosurgery using
a brachytherapy template with at least 12 months of PSA followup.
Immediate and delayed morbidities were evaluated. PSA results at 3 and
12 months were recorded, and failure was defined as the inability to
reach a nadir of 0.4 ng/ml or less.
Results:
Complications in patients undergoing primary cryosurgery included
tissue sloughing (5%), incontinence (pads, 3%), urge incontinence/no
pads (5%), transient urinary retention (3.3%) and rectal discomfort
(2.6%). There were no cases of fistulas or infections. Postoperative
impotence was 87% in previously potent patients. For patients who
underwent salvage cryosurgery there were no fistulas reported and 2
(11%) patients required pads after salvage cryosurgery. A total of 96
(81%) patients achieved a PSA nadir of 0.4 ng/ml or less at 3 months
of followup, while 79 of 106 (75%) remained free from biochemical
recurrence at 12 months. A total of 42 (78%) low risk patients
(Gleason score 7 or less and PSA 10 or less) remained with a PSA of
0.4 ng/ml or less at 12 months of followup, compared to 37 (71%) high
risk patients. All patients were discharged within 24 hours.
Conclusions:
After a followup of 1 year 3rd generation cryosurgery appears to be
well tolerated and minimally invasive. The use of ultrathin needles
through a brachytherapy template allows for a simple percutaneous
procedure and a relatively short learning curve. A prospective
multicenter trial is ongoing to determine the long-term efficacy of
this technique.